Manitobans on hook for $40M in unpaid medical bills racked up by non-Canadians

Non-Canadians have stiffed Manitoba’s health-care system for $40 million in the last five years.

Shared Health averaged about $7.9 million in losses each fiscal year between 2020 and 2025. The figures were released via a freedom of information request that was submitted by SecondStreet.org, an Alberta-based think tank.

“The big picture in Canada is that we have a system that’s in crisis from coast to coast, and if these dollars had been spent on helping Canadians with health care, then that could ease some of the pressure on the system.” said Colin Craig, president of SecondStreet.org, on Tuesday.

“Canadian taxpayers are spending millions of dollars on health-care services for people who don’t even live in Canada.”

Permanent residents, work permit holders and some refugee claimants can qualify for public health coverage in Manitoba — but tourists, transients, visitors and most study permit holders cannot, says the Manitoba Health website.

Non-residents left taxpayers on the hook for $3.8 million in fiscal 2020-21, $8.2 million in 2021-22, $4.5 million in 2022-23, $18.7 million in 2023-24 and $4.5 million in 2024-25, the Shared Health data shows.

SecondStreet.org estimated the unpaid amount could have paid for hip replacement operations for about 3,400 patients. The numbers are based on a patient cost estimator tool created by the Canadian Institute for Health Information.

Freedom of information requests filed with other provincial health authorities show a similar issue persists in Alberta, where losses totalled $92.3 million since 2020-21, and in British Columbia, where they reached $200.6 million in the same period.

Craig outlined three potential policy solutions his organization believes could cut the amount unpaid: Provincial health regions should require visitors to pay upfront before treatment, except when they require lifesaving care; people admitted to Canada should be required to have travel insurance before entering the country, and they should be banned from re-entering the country if they have outstanding medical bills.

The Free Press has reached out to Health Minister Uzoma Asagwara for comment.

Manitoba Nurses Union president Darlene Jackson called the amount “shocking.”

“I can’t help but thinking that this money being poured back into our health-care system would absolutely benefit staff as well as patients,” Jackson said.

The union leader said she was not aware of the issue until Tuesday. Nurses who provide care to patients have no connection to bills issued to them.

“Now, more than ever, we need to be looking at utilizing every dollar that we have in health care,” she said.

“Let’s say I go to the U.S. and go to a hospital — I am billed, there’s no two ways about it. I have to pay before I leave. So, I think it’s really important that we look at how we can actually collect this money.”

An injection of $40 million could help bolster staffing, Jackson said.

A spokesperson for Doctors Manitoba said the amount of money unpaid likely exceeds $40 million because the numbers provided by Shared Health do not account for the cost of physician services.

While hospitals in Manitoba are funded by provincial health authorities, physicians are paid directly by Manitoba Health for each insured service they provided.

This means physicians are responsible for billing non-Canadian patients or their insurers and following up on outstanding accounts. Doctors Manitoba has raised concerns about this process with the province, their statement says.

“As a result, there are likely millions of dollars in additional physician services that have also gone unpaid over the same period,” the spokesperson said.

“While unpaid hospital costs are ultimately absorbed by the publicly funded health system, physicians are often left to absorb the financial loss when their services go unpaid.”

Andrew Longhurst, a senior research with the Canadian Centre for Policy Alternatives, questioned the motivations of SecondStreet.org, noting the organization has pushed for greater involvement of private health care in Canada.

“They are trying to rile people up and make them, I think, blame people who are migrants, people who are of colour, people who are trying to make a better life,” he said.

Longhurst noted the $40 million loss over five years is little more than a “rounding error” when compared to Manitoba’s overall health budget, which is slated to reach $10.6 billion in 2026-27.

“I don’t really see what they are making a fuss out of about in terms of this. I think the benefit of tourism and having people in Manitoba far out weighs the very small cost associated with that,” Longhurst said.

“If you’re going to put resources toward litigating or going after those dollars, you’re probably going to end up spending more than you would actually bring back.”

Noah Schulz, director of the Manitoba Health Coalition, agreed.

“We have much bigger issues in public health care in Manitoba and in Canada than tourists costing the system,” Schulz said.

He described the policy recommendations presented by Craig as shortsighted, warning there could be unintended consequences for visitors and Canadians alike.

“In terms of policy solutions — if this is a problem that we want to address — would be in terms of more reciprocal health-care agreements between Canada and other countries.”

tyler.searle@freepress.mb.ca